Question 1

All of the following steps should be used to prepare a smear from thick, granular, or mucoid materials, except:

Accepted Answer

A)  Place a portion of the sample on the labeled slide, and press a second slide onto the sample to flatten or crush the components. 
B)  Once the material is flattened and sufficiently thinned, pull the glass slides smoothly away from each other to produce two smears. 
C)  Take an additional swab and rub it back and forth on the two glass slides to ensure the material is thin enough to read once it is stained. 
D)  If the material is still too thick, repeat the first three steps with another (third) glass slide. 
A)  Place a portion of the sample on the labeled slide, and press a second slide onto the sample to flatten or crush the components. 
B)  Once the material is flattened and sufficiently thinned, pull the glass slides smoothly away from each other to produce two smears. 
C)  Take an additional swab and rub it back and forth on the two glass slides to ensure the material is thin enough to read once it is stained. 
D)  If the material is still too thick, repeat the first three steps with another (third) glass slide. C

Question 2

The direct microscopic examination of infected materials, along with specimen site and historical information, may suggest modifications in routine culture techniques to allow the isolation of a suspected pathogen. Common modifications include all of the following, except

Accepted Answer

A)  ordering other culture tests. 
B)  adding special media. 
C)  changing incubation temperature or atmosphere. 
D)  changing the amount of humidity in the incubator. 
A)  ordering other culture tests. 
B)  adding special media. 
C)  changing incubation temperature or atmosphere. 
D)  changing the amount of humidity in the incubator. D

Question 3

A bacterial smear may indicate a polymicrobial infection when

Accepted Answer

A)  mucus, red blood cells, neutrophils, and necrosis are on the smear. 
B)  lymphocytes, monocytes, and macrophages are on the smear. 
C)  more than one morphologic type of bacteria is present on the smear. 
D)  both gram-negative rods and gram-positive cocci are present on the smear. 
A)  mucus, red blood cells, neutrophils, and necrosis are on the smear. 
B)  lymphocytes, monocytes, and macrophages are on the smear. 
C)  more than one morphologic type of bacteria is present on the smear. 
D)  both gram-negative rods and gram-positive cocci are present on the smear. C

Question 4

Culture results

Accepted Answer

A)  confirm the correctness of the therapeutic choices already made and implemented. 
B)  help the physician select an antibiotic for treatment. 
C)  must be confirmed before initiating antibiotic treatment for a patient. 
D)  help confirm the patient's high white blood count. 
A)  confirm the correctness of the therapeutic choices already made and implemented. 
B)  help the physician select an antibiotic for treatment. 
C)  must be confirmed before initiating antibiotic treatment for a patient. 
D)  help confirm the patient's high white blood count.

Question 5

What elements should be included in the direct examination of a microbial smear?

Accepted Answer

A)  Only those elements useful in characterizing the specimen 
B)  Only elements pertaining to the necrosis present in the specimen 
C)  Only those elements pertaining to the amount of gram-positive cocci present in the specimen 
D)  Only those elements of contaminating material present in the specimen 
A)  Only those elements useful in characterizing the specimen 
B)  Only elements pertaining to the necrosis present in the specimen 
C)  Only those elements pertaining to the amount of gram-positive cocci present in the specimen 
D)  Only those elements of contaminating material present in the specimen

Question 6

Commonly encountered polymicrobial infections are common in

Accepted Answer

A)  perirectal abscesses. 
B)  indwelling catheter infections. 
C)  infant meningitis. 
D)  food poisoning. 
A)  perirectal abscesses. 
B)  indwelling catheter infections. 
C)  infant meningitis. 
D)  food poisoning.

Question 7

When a laboratory professional examines a specimen smear, he or she should be looking for all of the following, except

Accepted Answer

A)  squamous epithelial cells. 
B)  mucus. 
C)  bacteria without the cells of inflammation. 
D)  debris. 
A)  squamous epithelial cells. 
B)  mucus. 
C)  bacteria without the cells of inflammation. 
D)  debris.

Question 8

When examining specimen smears for pathogenic bacteria, this is important to note.

Accepted Answer

A)  Wright stain reaction 
B)  Intracellular and extracellular forms 
C)  Details of the microbe's nuclear structure 
D)  The amount of fecal material on the slide 
A)  Wright stain reaction 
B)  Intracellular and extracellular forms 
C)  Details of the microbe's nuclear structure 
D)  The amount of fecal material on the slide

Question 9

Contaminating materials include all the following, except

Accepted Answer

A)  crystallized Gram stain. 
B)  materials not coming from the collection site. 
C)  materials not contributed by the inflammatory response from the tissues. 
D)  materials not likely to contain the infecting organism. 
A)  crystallized Gram stain. 
B)  materials not coming from the collection site. 
C)  materials not contributed by the inflammatory response from the tissues. 
D)  materials not likely to contain the infecting organism.

Question 10

All the following cells reflect chronic inflammation, except

Accepted Answer

A)  lymphocytes. 
B)  neutrophils. 
C)  monocytes. 
D)  macrophages. 
A)  lymphocytes. 
B)  neutrophils. 
C)  monocytes. 
D)  macrophages.

Question 11

In the microbiology laboratory, this instrument is routinely used to examine smears for structures that are too small to be seen with the unaided eye.

Accepted Answer

A)  Cytocentrifuge 
B)  Thermal cycler 
C)  Compound microscope 
D)  Electron microscope 
A)  Cytocentrifuge 
B)  Thermal cycler 
C)  Compound microscope 
D)  Electron microscope

Question 12

Because cell wall-damaged bacteria, antibiotic-treated bacteria, or dead bacteria may appear falsely gram-negative, the following are considered "critical cocharacteristics" that assist in the interpretation of the smear include

Accepted Answer

A)  color and cell wall composition. 
B)  growth characteristics. 
C)  shape and size. 
D)  size and color. 
A)  color and cell wall composition. 
B)  growth characteristics. 
C)  shape and size. 
D)  size and color.

Question 13

Bartlett's method for scoring sputum and the Murray-Washington method for contamination assessment associate what with unacceptable sputum specimens?

Accepted Answer

A)  10 to 25 neutrophils/10$\times$ field 
B)  Greater than 25 neutrophils/10$\times$ field 
C)  10 to 20 squamous epithelial cells/10$\times$ field 
D)  Less than 10 squamous epithelial cells/10$\times$ field 
A)  10 to 25 neutrophils/10$\times$ field 
B)  Greater than 25 neutrophils/10$\times$ field 
C)  10 to 20 squamous epithelial cells/10$\times$ field 
D)  Less than 10 squamous epithelial cells/10$\times$ field

Question 14

Why should laboratory professionals look for contamination of a specimen by normal microbial flora?

Accepted Answer

A)  Contaminated specimens will have much amorphous debris that also goes with them. 
B)  Normal flora always preclude the possibility of a pathogen infecting the area where they reside. 
C)  The normal flora will be found in clumps, and any pathogenic bacteria will be found with the normal flora. 
D)  Contamination of specimens with normal flora that are not collected from sterile sites diminishes the value of the culture studies. 
A)  Contaminated specimens will have much amorphous debris that also goes with them. 
B)  Normal flora always preclude the possibility of a pathogen infecting the area where they reside. 
C)  The normal flora will be found in clumps, and any pathogenic bacteria will be found with the normal flora. 
D)  Contamination of specimens with normal flora that are not collected from sterile sites diminishes the value of the culture studies.

Question 15

You are working in a microbiology laboratory and receive a sputum for culture. You perform a Gram stain on the sputum and get the following results: 3+ gram-positive cocci, greater than 25 epithelial cells/10$\times$ field, less than 10 neutrophils/10$\times$ field, and heavy mucus. What do these results indicate?

Accepted Answer

A)  An acceptable specimen that should be worked up with definitive identification for all bacteria present 
B)  An unacceptable specimen and workup that should be limited to basic identification of bacteria 
C)  An unacceptable specimen that should be worked up with definitive identification for all bacteria present 
D)  An acceptable specimen and workup that should be limited to the basic identification of bacteria 
A)  An acceptable specimen that should be worked up with definitive identification for all bacteria present 
B)  An unacceptable specimen and workup that should be limited to basic identification of bacteria 
C)  An unacceptable specimen that should be worked up with definitive identification for all bacteria present 
D)  An acceptable specimen and workup that should be limited to the basic identification of bacteria

Question 16

To assist the physician and the laboratory professional in interpreting sputum smears, all of the following local materials are quantitated, except

Accepted Answer

A)  microbial flora. 
B)  neutrophils. 
C)  epithelial cells. 
D)  mucus. 
A)  microbial flora. 
B)  neutrophils. 
C)  epithelial cells. 
D)  mucus.

Question 17

Local materials that may be added in the criteria for accepting or rejecting a respiratory specimen include all the following, except

Accepted Answer

A)  mucus. 
B)  macrophages. 
C)  bacterial ropes. 
D)  ciliated columnar cells. 
A)  mucus. 
B)  macrophages. 
C)  bacterial ropes. 
D)  ciliated columnar cells.

Question 18

All of the following are signs of acute inflammation on a bacterial smear, except

Accepted Answer

A)  mucus. 
B)  red blood cells. 
C)  neutrophils. 
D)  protein background. 
A)  mucus. 
B)  red blood cells. 
C)  neutrophils. 
D)  protein background.

Question 19

The purpose of a simple stain is to

Accepted Answer

A)  color specific components of specific elements. 
B)  color the forms and shapes present. 
C)  specifically identify an organism. 
D)  identify the types of DNA and RNA present in the nucleus of a cell. 
A)  color specific components of specific elements. 
B)  color the forms and shapes present. 
C)  specifically identify an organism. 
D)  identify the types of DNA and RNA present in the nucleus of a cell.

Question 20

Polymicrobial presentations in smears require more interpretation and must take into account all the following, except

Accepted Answer

A)  smear background. 
B)  morphology of the organisms. 
C)  anatomic location of the suspected infection. 
D)  method used to make the smear. 
A)  smear background. 
B)  morphology of the organisms. 
C)  anatomic location of the suspected infection. 
D)  method used to make the smear.

Exam 7: Microscopic Examination of Materials From Infected Sites

All of the following steps should be used to prepare a smear from thick, granular, or mucoid materials, except:

The direct microscopic examination of infected materials, along with specimen site and historical information, may suggest modifications in routine culture techniques to allow the isolation of a suspected pathogen. Common modifications include all of the following, except

A bacterial smear may indicate a polymicrobial infection when

Culture results

What elements should be included in the direct examination of a microbial smear?

Commonly encountered polymicrobial infections are common in

When a laboratory professional examines a specimen smear, he or she should be looking for all of the following, except

When examining specimen smears for pathogenic bacteria, this is important to note.

Contaminating materials include all the following, except

All the following cells reflect chronic inflammation, except

In the microbiology laboratory, this instrument is routinely used to examine smears for structures that are too small to be seen with the unaided eye.

Because cell wall-damaged bacteria, antibiotic-treated bacteria, or dead bacteria may appear falsely gram-negative, the following are considered "critical cocharacteristics" that assist in the interpretation of the smear include

Bartlett's method for scoring sputum and the Murray-Washington method for contamination assessment associate what with unacceptable sputum specimens?

Why should laboratory professionals look for contamination of a specimen by normal microbial flora?

To assist the physician and the laboratory professional in interpreting sputum smears, all of the following local materials are quantitated, except

Local materials that may be added in the criteria for accepting or rejecting a respiratory specimen include all the following, except

All of the following are signs of acute inflammation on a bacterial smear, except

The purpose of a simple stain is to

Polymicrobial presentations in smears require more interpretation and must take into account all the following, except

Bacterial Cell Structure, Physiology, Metabolism, and Genetics

Hostparasite Interaction

The Laboratory Role in Infection Control

Control of Microorganisms

Performance Improvement in the Microbiology Laboratory

Specimen Collection and Processing

Use of Colony Morphology for the Presumptive Identification of Microorganisms

Biochemical Identification of Gram-Negative Bacteria

Immunodiagnosis of Infectious Diseases

Applications of Molecular Diagnostics

Antimicrobial Agent Mechanisms of Action and Resistance Mechanisms

Antimicrobial Susceptibility Testing

Staphylococci

Streptococcus, Enterococcus, and Other Catalase-Negative, Gram-Positive Cocci

Aerobic Gram-Positive Bacilli

Neisseria Species and Moraxella Catarrhalis

Haemophilus, Hacek, Legionella, and Other Fastidious Gram-Negative Bacilli

Enterobacteriaceae

Vibrio, Aeromonas, and Campylobacter Species

Nonfermenting and Miscellaneous Gram-Negative Bacilli

Anaerobes of Clinical Importance

The Spirochetes

Chlamydia, Rickettsia, and Similar Organisms

Mycoplasma and Ureaplasma

Mycobacterium Tuberculosis and Nontuberculous Mycobacteria

Medically Significant Fungi

Diagnostic Parasitology

Clinical Virology

Agents of Bioterror and Forensic Microbiology

Biofilms: Architects of Disease

Upper and Lower Respiratory Tract Infections

Skin and Soft Tissue Infections

Gastrointestinal Infections and Food Poisoning

Infections of the Central Nervous System

Bacteremia and Sepsis

Urinary Tract Infections

Genital Infections and Sexually Transmitted Infections

Infections in Special Populations

Zoonotic Diseases

Ocular Infections

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